2019 年第 9 期 第 14 卷

关节镜清理术联合功能锻炼用于膝关节屈曲畸形患者的临床效果

Clinical effect of arthroscopic debridement combined with functional exercise on knee flexion deformity

作者：梁治权吴迎波邓迎杰刘振峰方锐

英文作者：

单位：830000乌鲁木齐，新疆医科大学附属中医医院骨二科

英文单位：

关键词：膝关节屈曲畸形；关节镜清理术；功能锻炼；膝关节功能

英文关键词：

• 摘要：

• 【摘要】目的    探讨关节镜清理术联合功能锻炼用于膝关节屈曲畸形患者的临床效果。方法    选取2015年10月至2017年12月于新疆医科大学附属中医医院骨科接受诊疗的90例膝关节屈曲畸形患者为研究对象。按照随机数字表法分为对照组与观察组，各45例。对照组仅采用膝关节镜清理术治疗，观察组在此基础上联合术后功能锻炼。比较2组临床疗效、治疗前后徒手肌力检查评分、主动关节活动度及Muller膝关节稳定性评分、疼痛视觉模拟量表评分及美国西部Ontario和McMaster大学骨关节炎指数评分。结果    观察组临床总有效率明显高于对照组［93.3%（42/45）比77.8%（35/45）］，差异有统计学意义（P＜0.05）。治疗后2组徒手肌力检查评分、主动关节活动度、膝关节屈曲角度及Muller膝关节稳定性评分均明显高于/大于治疗前，且观察组高于/大于对照组［（5.5±1.0）分比（4.0±0.8）分、（46±8）°比（39±6）°、（133±15）°比（117±10）°、（6.4±1.3）分比（5.4±1.1）分］，差异均有统计学意义（均P＜0.01）。治疗后2组疼痛视觉模拟量表及美国西部Ontario和McMaster大学骨关节炎指数评分均明显低于治疗前，且观察组低于对照组［（1.8±0.4）分比（2.9±0.6）分、（13±4）分比（20±3）分］，差异均有统计学意义（均P＜0.01）。结论    关节镜清理术联合功能锻炼治疗膝关节屈曲畸形效果显著，可有效改善膝关节功能，缓解患者疼痛。

• 【Abstract】Objective    To investigate the clinical effect of arthroscopic debridement combined with functional exercise on patients with knee flexion deformity. Methods    Ninety knee flexion deformity patients admitted to Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University from October 2015 to December 2017 were randomly divided into control group and observation group, with 45 cases in each group. The control group was treated with arthroscopic debridement; the observation group underwent arthroscopic debridement combined with functional exercise. Clinical efficacy, manual muscle testing(MMT) score, active range of motion(AROM), Muller knee joint stability score, Visual Analogue Scale(VAS) score and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) score were analyzed. Results    Total clinical effective rate in the observation group was significantly higher than that in the control group［93.3%（42/45） vs 77.8%（35/45）］(P<0.05). MMT score, AROM, knee flexion angle and Muller knee joint stability score significantly increased after treatment in both groups; the indexes in the observation group were significantly higher/larger than those in the control group［（5.5±1.0） vs （4.0±0.8）, （46±8）° vs （39±6）°, （133±15）° vs （117±10）°, （6.4±1.3） vs （5.4±1.1）］（all P＜0.01）. Scores of VAS and WOMAC after treatment were significantly lower than those before treatment; the scores in the observation group were significantly lower than those in the control group［（1.8±0.4） vs （2.9±0.6）, （13±4） vs （20±3）］(all P<0.01). Conclusion    Arthroscopic debridement combined with functional exercise is effective in the treatment of knee flexion deformity, it can effectively improve knee joint function and relieve pain.